The sex positions to try if you have knee problems, according to an osteopath

Finding the perfect sex position for knee problems can be a difficult task for some. Avoiding discomfort in the bedroom is essential but knee pain can be caused by many different issues and affect one or multiple parts of the joint - including the bones, ligaments, tendons, and nerves. So, what works for one person may not work for another. 

What's certain is that some sex positions - particularly those that require one or both partners to kneel, crouch, or squat - are more likely to cause pain during sex than others. Depending on knee placement though, even just lying down can cause issues for some people. 

Naturally, if you're in pain with no visible cause, you should talk to your doctor. But if you regularly experience discomfort around the knees have it under control or you're in recovery from minor knee surgery, we've got the sex positions for you to try - and many of them feature on our list of the best sex positions overall. 

What causes knee problems during sex?

There are a few things that can cause discomfort during sex for those with knee problems, aside from conditions like arthritis, says Phyllis Woodfine, an osteopath with over 20 years of experience in the industry.

• Laying in one position for too long: Whether you already have pre-existing knee problems or not, a common cause of discomfort is staying in one position for too long. "If the knee is in an awkward position for a longer period of time, this can cause issues," says the osteopath.
• Kneeling down: The pressure of a surface against the kneecaps can also cause issues, she says. "It may be that actually kneeling down on all fours is the cause of pain, especially if you have arthritis or meniscal pain, for example." The meniscus is cartilage that sits between the shin and thigh bone and tears of this cartilage are among some of the most common knee injuries. 
• Repeated stress on the knee: Moves that require either partner to repeatedly squat or put pressure on the knee can certainly cause issues in the bedroom. If you're not used to regularly flexing the knees and do so vigorously in a short space of time, it's bound to cause an issue. 
• A lack of mobility: If you struggle with mobility in your knees, this can cause issues in the bedroom too. Many positions require couples to stretch their knees out to the side, bunch them up, or have their legs out totally straight, all of which can cause issues depending on the cause and severity of the knee problems.

Although many people don't discuss the impact of knee problems on their sex lives with doctors and physiotherapists, issues such as musculoskeletal pain, stiffness, and muscle awkwardness are also among the most reported, per research by Örebro University.

Knee problems don't mean you have to miss out on all the joyful benefits of sex though - and you can still spice things up in the bedroom. Here are a few moves to try, as recommended by Woodfine. 

Sex positions to try if you have knee problems

1. Missionary

Missionary is a favourite for a reason - it works in just about every situation, whether you're looking for relaxed and lazy sex positions or positions to alleviate knee pain. 

In this classic move, the receiving partner lies on their back with their legs spread. The other partner then positions themselves over the top. 

While many people will find this comfortable enough, Woodfine says "the best thing would be to position a pillow or towel to support the knees while you are lying on your back." This could mean spreading the legs out to the sides, bending at the knee, and using a pillow under each knee's side to support its weight, or positioning the pillow directly underneath each knee with the leg outstretched. 

2. Spooning

"Laying side by side would help to prevent knee pain if having them bent causes additional pain," explains the osteopath, citing the benefits of the spooning sex position. "[This position] would help the partner with the painful knees at the front."

Much like the romantic cuddling position, both partners lie on their sides and one person penetrates the other from behind in this sex position. The partner in front can rest their knees against each other, pushing their buttocks into the groin area of their partner. Alternatively, you can use the support of a pillow under the side of the knee closest to the bed or you can sandwich a pillow between the two knees. Whatever feels most comfortable. 

3. Butterfly sex position

The butterfly sex position is another favourite and should definitely be on your list of ones to try if you're looking for the best sex positions for lower back pain, knee problems, or any aches and pains really. 

This move has the receiving partner lying down with their back resting on the bed (or table, more commonly). The other partner then enters from a standing position at the end of the bed or table, using the structure for support when needed. 

"You could have your legs supported on a chair or on pillows, or if you are flexible enough, your partner's shoulder," Woodfine offers. "For this, you may need to be closer to the end of the bed, table, or chair."

4. 69

When it comes to the best oral sex positions for those looking to prevent knee problems in the bedroom, it's got to be the 69 sex position with a couple of modifications, says Woodfine.

"You may want to perform oral sex in the 69 position either sideways, on your back, or in a sitting position so that you are not on your knees as you perform," she adds.

5. Cowgirl

Much like missionary, the cowgirl sex position is a popular move. For those who love the deep penetration of doggy style but want to avoid the discomfort that comes from kneeling, this could be a good alternative. 

"Another position would be with you sitting or straddling your partner to prevent pressure on your knees," says Woodfine, pointing out that the reverse cowgirl would work equally well. "This may help prevent pain during sex either whilst on a chair or on the bed facing your partner." 

If it's not uncomfortable to put weight on the knee, you can try the cowgirl on a chair. This would completely take away any external pressure of a partner's potential body weight on your knees, or having to flex them out to the sides. To do the move, have the giving partner sit down on a chair and position the receiving partner over them. Bending at the knee, the receiving partner gently sits down on top of the partner on the chair, bouncing gently or grinding their way to orgasm. 

6. Standing sex position

One of the many standing sex positions could also be beneficial for those needing to prevent knee pain during sex. "A standing position with your partner behind you and you leaning on a supportive counter/ table/bed or furniture can provide balance and support at the right height," says Woodfine. 

7. Reverse speed bump

You may have heard of the speed bump sex position before. This alternative take on doggy style has the receiving partner lying on their front with a pillow propped under their pubic bone, legs slightly parted. 

The reverse speed bump is very similar - except the receiving partner is lying on their back, taking away any external pressure on the knees. The pillow, which should tuck under the bottom partner's buttocks, gives the legs more room to move.

If you do prefer more doggy-style moves, the leapfrog sex position could be beneficial for those dealing with knee problems.

Tips for dealing with knee problems during sex

• Experiment with different positions: "It's always good to experiment with your positions," says Woodfine when searching for your best sex position for knee problems. "Modified missionary positions may help, but of course, it depends on what the cause of the knee pain is and where you feel the pain. Experimenting to find what works for you is best if you're looking to find the best sex position for knee problems for you."
• Have sex in the morning: Sex in the morning isn't just a known mood booster. While many people find their joints stiff in the morning, making sex more uncomfortable, others will find that the morning is when their knees are the least tired and better able to handle pressure. 
• Take up regular exercise: Going cycling or riding a stationary bike at least twice a week will be beneficial for your knees, research from the University of Canberra explains. As a low-impact workout, it helps to strengthen the leg muscles - like the thighs, hamstrings, and calves - without putting excessive force through the joints.
• Have a bath before you get to the bedroom: We all know the benefits of having a bath to help us relax and get in the mood but warm water can also help to preemptively alleviate joint pain for some people.  
• Prepare your knees: Dependant on advice from your doctor, you can prepare your knees in advance if you are looking to do more predictably-troublesome moves, says the osteopath. "Ice the knee beforehand and place a towel or small pillow under the knees," says Woodfine.